City Applied For

Piaggio Vehicles Pvt. Ltd.

Two Wheeler Business

Dealership Application Form

Motoplex P3 (Vespa, Aprilia, MotoGuzzi)

Vespa Motoplex P2 (Vespa, Aprilia Scooters)

Applied By:

Name Mobile Email

Date (dd/mm/yy)

Document Number: Ref: /PVPL/2W/Vespa/DPFV14/DDMM/____

Instructions

1. Please fill in all the sections in the proposal form. 2. Please ensure that the application form is complete in all aspects. Incomplete applications may

get rejected by PVPL team. 3. Please submit all relevant documents in support of the information provide along with

the documents detailed in last page. 4. Email a copy to abdul.khan@piaggio.co.in with all relevant documents (In case of additional

information, you may please attach enclosures) 5. Submit the printed copy of the completed form along with all the required documents at

the following address: Channel & Business Development Piaggio Vehicles Private Limited (Two Wheeler Business) 4th Floor “Sky One” Plot No. 72, Next to Clover Water Garden Kalyani Nagar, Pune - 411006 Maharashtra, India +91-20-6749-2400

6. The applicant acknowledges that copies of all documents, photographs etc. furnished by him to

PVPL in the process of applying for dealership will henceforth become a property of PVPL and will be retained by them for their records.

7. The applicant has made full disclosure of all the information required in this application and all the

information given by him is true in all respects. The applicant further acknowledges that any misrepresentation, whether intentional or unintentional, in the information submitted in the connection with the application shall be grounds upon which PVPL may either-

a) Decide to no longer consider his application, or b) Immediately terminate any dealership agreement executed by PVPL with him or the dealer

company designed by him.

8. PVPL reserves the right to reject any application without assigning any reason whatsoever and the decision of PVPL shall be final and binding on the party.

9. Please note PVPL stands for “Piaggio Vehicles Private Limited” in the form. 10. Please sign and stamp on all the pages of application form and documents before submission.

11. Please super scribe the envelope with; “Dealership”.

Name Signature Date 1 | P a g e

Section A Proposed Dealer Principle’s Profile

1. Key Applicant’s Profile Name

Date of Birth

Phone

Mobile

Email Photograph Address

Of

Key Applicant

City

State

PIN

2. Educational & Professional Qualification of Applicant(s) Relationship

Highest

Present

Proposed %

Sr. No.

Name

With Main

Age

Holding in

Qualification Occupation

Applicant Dealership

1

2

3

3. Details of any other members who could be part of the management: Member 1 Member 2

Name

Relationship with the Applicant

Designation Company

Mobile

Email Id

3. Personnel Financial Status (Key Applicant)

Asset Class

Asset Details

Value

Liability Class

Liability Details

Value

In Lacs In Lacs

Cash Bank Borrowing

Securities Personal Loans

Real Estate Income Tax

Liabilities

Household Items

Others

Business

Investment

Total Asset [A] Total Liabilities [L]

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Section B Business Profile (Existing Businesses)

1. Company Structure

Proprietorship

Partnership

Private Limited

For Proprietorship

Sr. No. Company Designation From Date To Date Duration Turnover (Lac)

1

2

3

For Partnership

Sr. No.

Name

Qualification

Age

Work Experience in

Capital Contribution

Rupees in In

Years

Thousand

Percentage

1

2

3

4

More Details:

For Private Limited/Public Limited

Work

% Share

Designation/

Sr. No.

Name

Qualification

Age

Experience

Holding Responsibility

(Inn Years)

1

2

3

4

More Details:

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Section C

Financial Details (Existing Business)

1. Financial Details

Rupees- In Lacs Representation Financial Details

FY 15-16

FY 16-17

FY 17-18

(Projected)

A Total Paid up Capital

B Reserve & Surplus

C = A+B Net Worth (A+B)

D Medium & Long Term Loans

E Book Value of Fixed Assets

F Turn Over

G Profit Before Tax

H Profit After Tax

I Total Manpower Deployed

2. Banker Details

Sr. No.

Bank Name & Address

Type of Limit Details of Assets Hypothecated

Facility Sanctioned & Their Market Value

1

2

3

4

3. Financial & Professional Details

Type of

Business Year of

Type of Nominated Turnover Net Worth Turnover Net Worth

Company Name Establish- Family (Lacs) (Lacs) (Lacs) (Lacs)

Business Locations Company

Au

tom

ob

ile

ment

Member

2015-16

2015-16

2016-17

2016-17

Total 1

No

n A

uto

mo

bile

Total 2

Total (1+2)

Type of Business: Trading, Manufacturing, Service, Retails etc. Type of Company: Private Ltd., Partnership, Proprietorship

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Section D

PVPL – 2W Dealership Proposal Details

1. Do you propose to make new company:

Yes

No

If No, Which existing company will operate proposed Vespa Dealership?

Name of the Company

Year of Formation

GST

PAN Turn Over (In Lac)

If Yes, Mention the details-

a) Type of Firm:

Proprietorship

Partnership

Private Limited

b.1) For Proprietorship Firm

Candidate

Source of Funds

b.2) For Partnership & Private Limited (Proposed Share Holding Pattern)

Sr. No.

Name

Relationship

Proposed % Share

Holding

1

2

3

2. Investment (In Lac)

Sr. No. Types of Funds Long Term Working Capital

1 Own Funds

2 Term Loans

3 Total (1+2)

4 Source of Funds

5 Time Frame to Source Funds

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Section E

1. City Information Market Information

City Population Area

Industries Present

Other Economic Activity

Automobile Brands Present in Town (4W)

Automobile Brands Present in town (2W)

Automobile Brands Present in Town

(Superbike/Premium 2W)

2. Market Potential Sr.

No. of Super Bike Sales Scooter Sales Motorcycles Sales

Brand

No. Dealers (Per Month) (Per Month) (Per Month)

1 Honda Motorcycles & Scooters

2 Hero Moto Corp.

3 TVS Motors Ltd.

4 Suzuki Motors

5 Mahindra Two Wheelers

6 Yamaha Motors India

7 Enfield India

8 Bajaj Auto

9 Ducati

10 Harley Davidson

11 BMW

12 Triumph

13 Others

3. Expected Sales Volume (Unit)

Sr. No.

Model Year 1

(Average Per Month) Year 2

(Average Per Month) Year 3

(Average Per Month)

1 Vespa 125/150

2 Aprilia SR 125/150

3 Aprilia

4 MotoGuzzi

Total

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Section F

Infrastructure Details

Sr. No. Heads Showroom Workshop Stockyard

1 Plot Size (Sq. Ft.)

2 Covered Area (Sq. Ft.)

3 Open Area (Sq. Ft.)

4 Plot Frontage (Ft.)

5 Build-up Area Frontage (Ft)

6 Nearby Landmark

7 Ownership Status (Owned/Rented/Leased)

8 Type of Work (Renovation/Major Renovation/ Green field)

9 Time Required to Complete as Per Norms (From Date of Issue of LOI- In Days)

10 Address

11 Pin-code

12 Location

Any Other Details:

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City Map

(With Location Mapping of Proposed Site & Completion Dealerships)

Paste here

(Multiple Photos)

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Photographs

Showroom Pictures: Outside & Inside

(Close Right Angular Shot)

Paste here

(Multiple Photos)

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Photographs

Workshop Pictures: Outside & Inside

(Close End)

Paste here

(Multiple Photos)

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Photographs (Brands present on the same street/ complex etc.)

Paste here

(Multiple Photos)

Paste here

(Multiple Photos)

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Family Tree

Sample

XYZ

Grand Father

72

Manufacturing-Wires

A A A

Father Uncle Uncle

46 57 52

Automobiles - Brand Automobiles - Brand Automobiles - Brand

A A Self/Applicant Sister

20 24

Hotel HR

A

Cousin

29

Hotel/Service

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Family Tree Please Fill Here

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Check List of Documents Please attach the below mentioned documents:

Check List

1 Copy of Memorandum/Articles of Association(For Private Limited)

2 Partnership Deed certified by Bankers, If Applicable.

3 Certificate of Registration.

4 GST Certificate duly certified by the C.A.

5 Property Ownership Documents/ Rental Agreement.

6 Audited Financial Statements for the last 3 years (Certified by C.A)

7 Net Worth Certificate duly certified by the C.A.

8 Letter from the Bank Indication Credit Limits & Financial Soundness.

9 Letter of Deployment of Working Capital.

10 Declaration of Own Assets with Documentary Proof.

11 Copy of Income Tax Returns filed for the last 3 years.

12 Income Tax and Tax Clearance Certificate (Latest)

13 Voters Card of Applicants.

14 Photocopy of Pan Card duly certified by C.A

15 Residential Proof of Applicants.

16 Location Layout Map.

17 Proposed Setup Layout (Showroom & Workshop)

Apart from above detailed documents, please attach documents to support information provided.

Data Protection Terms:

Please Sign all pages to authenticate the information provided.

PVPL may use your information for vetting and to ascertain your suitability to become a PVPL Partner. We may keep your information for a reasonable period and may to contact you about our requirements as and when required.

We may carry out necessary due diligence through our credit reference agencies to ascertain credit worthiness about you to prevent fraud & to verify identity. These agencies may carry out searches on based on your record. The information collected will be used by other credit grantors for making credit decisions about you and the people with whom you are financially associated.

We may share the information with our business partners, who may contact you, if required.

You also consent us to transfer your information to countries with different standards of data protection, if necessary for the stated purposes. If we do make such a transfer, we will ensure your information is appropriately protected.

You have a right to ask for a copy of your information and to correct any inaccuracies stated in the information.

Date Name

Place Signature with Stamp

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